DEVELOPMENT OF NEW OR ENHANCED MODELS FOR STATE-BASED OCCUPATIONAL SURVEILLANCE

Release Date:  March 15, 2000

RFA:  OH-00-008

National Institute for Occupational Safety and Health

Letter of Intent Receipt Date:  April 2, 2000
Application Receipt Date:       May 11,  2000

PURPOSE

The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2000 funds for cooperative agreement (U01) 
applications from a single State entity or consortia of State entities who 
are capable of, and interested in, participating in a State Occupational 
Surveillance Consortium (SOSC).  The goal of the SOSC is to develop model 
surveillance systems that can strengthen state-based occupational 
surveillance programs for occupational diseases, injuries, and hazards.   
Applications are sought that develop new or enhanced models for condition-
specific surveillance and intervention for targeted occupational injuries, 
illnesses, or hazards.  These projects must have high potential for 
implementation  in surveillance programs of other States.

HEALTHY PEOPLE 2010

CDC is committed to achieving the health promotion and disease prevention 
objectives of Healthy People 2010, a national activity to reduce morbidity 
and mortality and improve the quality of life.  This announcement is related 
to the focus area of occupational safety and health.  For information on the 
conference on Healthy People 2010, visit the internet site: 
http://www.health.gov/healthypeople.

ELIGIBILITY REQUIREMENTS

Applications may be submitted by State health departments or other State 
health agencies or departments that direct and coordinate the State's 
occupational surveillance program.  This eligibility includes health 
departments or other official organizational authority (agency or 
instrumentality) of the District of Columbia, the Commonwealth of Puerto 
Rico, any territory or possession of the United States, and federally 
recognized Indian tribal governments, Indian tribes, or Indian tribal 
organizations.  Other official State and territorial agencies with 
occupational safety and health jurisdiction may also apply.  Applicants other 
than health departments must apply in collaboration with and through their 
State and territorial health department.

MECHANISM OF SUPPORT

The administrative and funding instrument to be used for this program will be 
a cooperative agreement (U01), an "assistance" mechanism, in which 
substantial NIOSH scientific and/or programmatic involvement with the awardee 
is anticipated during performance of the activity.  Under the cooperative 
agreement, the NIOSH purpose is to support and/or stimulate the recipient's 
activity by involvement in and otherwise working jointly with the award 
recipient in a partner role.  Details of the responsibilities, relationships 
and governance of the project to be funded under cooperative agreement(s) are 
discussed later in this document under the section "Terms and Conditions of 
Award."

The total project period for an application submitted in response to this 
present RFA may not exceed three (3) years.  The anticipated award date is 
September 29, 2000.  The award and level of support depends on receipt of 
applications of high scientific merit.  Although this program is provided for 
in the financial plans of NIOSH, the award pursuant to this RFA is contingent 
upon the availability of funds for this purpose. 

AVAILABILITY OF FUNDS

Approximately $500,000 is available in fiscal year (FY) 2000 to fund 5-6 
awards under this RFA.  Average awards will be $100,000 in total costs 
(direct and facilities and administrative (F&A) costs) per year. 

Awards will be made for a 12-month budget period within a project period up 
to 3 years.  Continuation awards within the project period will be made on 
the basis of satisfactory progress and availability of funds in future years. 

USE OF FUNDS

Recipient should allocate funds for travel for one project staff to attend an 
annual three day meeting to be held in conjunction with the Annual Meeting of 
the Council of State and Territorial Epidemiologists. 

PREAPPLICATION QUESTIONS AND ANSWERS

Applicants are invited by NIOSH to attend a preapplication technical 
assistance conference on April 6, 2000 at 3:00 PM (Eastern time) to discuss:  
programmatic issues regarding this program,  how to apply, and questions 
regarding the content of the RFA.  This meeting is expected to last 
approximately two hours.  The meeting will be held at the NIOSH Alice 
Hamilton Laboratory located at 5555 Ridge Avenue, Cincinnati, Ohio, 45213.  
Applicants may also participate by telephone.  The conference name is 
Surveillance Methods.  The telephone bridge number is (800)-713-1971.  
Interested parties will need the conference code, 728950 to participate.

RESEARCH  OBJECTIVES

Background

Occupational safety and health surveillance refers to the ongoing, systematic 
collection, analysis, and interpretation of relevant health and hazard data 
essential to the planning, implementation, and evaluation of industrial 
safety, industrial hygiene, occupational health, and/or public health 
practice, closely integrated with the timely dissemination of these data to 
those who need to know.  The final link of the surveillance chain is the use 
of these data to develop prevention and control strategies.  A surveillance 
system includes a functional capacity for data collection, analysis, and 
dissemination linked to industrial safety, industrial hygiene, occupational 
health, and/or public health programs.  Surveillance systems can operate at 
one or more work organization or geo-political levels (e.g. plant, company, 
union, state or federal levels).  

Over the past quarter century, NIOSH has played a key role in the 
surveillance of occupational diseases, injuries, and hazards, complementing 
the important surveillance activities carried out by many States and several 
other Federal agencies, including the Bureau of Labor Statistics (BLS), the 
Occupational Safety and Health Administration (OSHA), the Mine Safety and 
Health Administration (MSHA), and the National Center for Health Statistics 
(NCHS).  NIOSH began developing a program of national occupational health 
surveillance activities in the early 1970s.  These initial efforts  involved 
hazard surveillance and health effects surveillance.  

Collaboration between NIOSH and States related to occupational safety and 
health surveillance began with the Surveillance Cooperative Agreements 
between NIOSH and States (SCANS), a program intended to increase State health 
department capacities in the area of occupational safety and health.  In 
addition to the Sentinel Event Notification Systems for Occupational Risks 
(SENSOR) Program operating in 13 States and the Fatality Assessment and 
Control Evaluation (FACE) Program operating in 20 States, current major 
collaborative surveillance-related activities between NIOSH and States 
include the Adult Blood Lead Epidemiology and Surveillance (ABLES) Program, a 
program that has grown from 4 States in 1987 to 28 States in 1999.

In 1997 NIOSH supported over a 3-year period the development of state-based 
surveillance programs for a number of target conditions (carpal tunnel 
syndrome, childhood injuries, noise-induced hearing loss, amputations, and 
dermatitis).   These experimental programs permitted the States to experiment 
with case ascertainment methods for the target condition and linked 
surveillance activities to appropriate follow-up or intervention activities 
within that State.  NIOSH continues to build state-based surveillance 
capacity among States to develop and carry out surveillance and related 
prevention activities.  NIOSH is committed to the development of state-based 
surveillance programs for occupational diseases, injuries, and hazards, and 
intends to award cooperative agreements which will be used to develop or 
enhance new models for condition-specific surveillance and intervention for 
targeted occupational injuries, illnesses, or hazards.

An integral part of this initiative is the establishment of a State 
Occupational Surveillance Consortium (SOSC).  One critical role of the SOSC 
is to ensure that the study designs and data collection protocols are uniform 
and compatible across recipients.  Such coordination is needed if 
new/enhanced surveillance approaches are to be used across State agencies.  
In order to accomplish that goal, the SOSC will establish a Coordination 
Committee (CC), comprised of one voting representative from each member of 
the consortium, to serve as the main governing board for the conduct of this 
research program.  In addition, the CC will serve as an advisory body for the 
common or shared protocols to be used in the studies.  NIOSH staff will serve 
as non-voting members of the CC.  

Objectives and Scope

NIOSH seeks project applications that assist in building State capacity, 
developing and evaluating model condition-specific surveillance and 
intervention activities,  thus expanding and refining the range of 
surveillance activities that were initially identified in 1995 (Guidelines 
for Minimum and Comprehensive State-based Activities in Occupational Safety 
and Health, DHHS (NIOSH) Publication No. 95-107, June 1995; 
http://www.cdc.gov/niosh/95-107.html).  Such model surveillance activities 
should be conceptualized, implemented, evaluated, and revised to advance the 
NIOSH-State partnership in developing practical surveillance models to be 
adopted by all States.  Although the focus of the model surveillance activity 
should be state-based, applicants may include approaches which permit 
neighboring States to work together to establish regional surveillance 
efforts.

Surveillance activities have been described that should aid applicants in 
developing model surveillance programs which could meet the needs of local 
and State agencies responsible for public health surveillance.  New or 
enhanced surveillance approaches must not only meet an applicants priorities, 
but must also have the potential for adoption by other States.  Additional 
information on state-based activities is available at the NIOSH web site 
http://www.cdc.gov/niosh/95-107.html.

USEFUL REFERENCES

National Institute for Occupational Safety and Health.  National Occupational 
Research Agenda. Cincinnati, OH: U.S. Department of Health and Human 
Services, Public Health Service, Centers for Disease Control and Prevention, 
National Institute for Occupational Safety and Health, DHHS (NIOSH) 
Publication No.96-115 (http://www.cdc.gov/niosh/nora.html). 

National Institute for Occupational Safety and Health. Guidelines for Minimum 
and Comprehensive State-based Activities in Occupational Safety and Health. 
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health 
Service, Centers for Disease Control and Prevention, National Institute for 
Occupational Safety and Health,  DHHS (NIOSH) Publication No. 95-107 
(http://www.cdc.gov/niosh/95-107.html).

COORDINATION  COMMITTEE  AND STATE SURVEILLANCE  MEETINGS

Principal investigators should include in their budget support for themselves 
and for at least one other person from their institutions integrally involved 
in the project to attend an annual program meeting of all members of the 
SOSC.  The meeting will be of three days duration and will be held in 
conjunction with the Annual Meeting of the Council of State and Territorial 
Epidemiologists.

The principal investigator should also budget for attendance at four 
Coordination Committee (CC) meetings of the SOSC during the first year and 
two in each subsequent year.  For budget preparation and project planning 
purposes, it should be assumed that these meetings will be held in 
Cincinnati, Ohio.  The CC will determine later where and when recurring CC 
meetings will be held.  The CC chair will coordinate the meetings to review 
and assess overall progress and provide the opportunity for investigators to 
exchange information and discuss research issues.
TERMS AND CONDITIONS OF AWARD

The Terms and Conditions of Award, below, will be incorporated in all awards 
issued as a result of this RFA. It is critical that each applicant include 
specific plans for responding to these terms.  These special Terms of Award 
are in addition to and not in lieu of otherwise applicable OMB administrative 
guidelines, HHS Grant Administration Regulations at 45 CFR Parts 74 and 92, 
and PHS Grant Administration policy statements.

Under the cooperative agreement, the NIOSH purpose is to support and/or 
stimulate the recipient's activity, by involvement in and otherwise working 
jointly with, the award recipient in a partner role, but it is not to assume 
direction, prime responsibility, or a dominant role in the activity.  
Consistent with this concept, the dominant role and prime responsibility for 
the activity resides with the awardee(s) for the project as a whole, although 
specific tasks and activities in carrying out the studies will be shared 
among the awardees and the NIOSH collaborators where appropriate, including 
the following.

1. Recipient Responsibilities

The recipient will coordinate project activities, scientifically and 
administratively at the awardee institution and at the other sites that may 
be supported by sub-contractors to this award.  The applicant will have 
primary authority and responsibility to define objectives and approaches;  to 
plan, conduct, and analyze data; and to publish results, interpretations, and 
conclusions of studies conducted under the terms and conditions of the 
cooperative agreement award.  Recipient will:

a.  develop a case ascertainment system appropriate for the surveillance 
condition(s), including either a case definition for each surveillance 
condition or the description of the existing data system;

b.  provide study participants with individual notification letters when 
medical tests are performed; 

c.  serve as a permanent member of the CC;

d.  develop and submit semiannual progress reports; 

e.  collaborate in the scientific reporting of findings; 

f.  provide program management oversight for the project;

g.  notify study participants of the overall study results, if applicable.

2.  NIOSH Responsibilities

NIOSH anticipates having substantial scientific programmatic involvement 
during conduct of this activity, through technical assistance, advice, and 
coordination.  NIOSH will:

a.  serve as a scientific liaison between the awardee and other program staff 
at NIOSH with experience in the occupational health issues of State 
surveillance programs;

b.  provide expert consultation in the area of occupational surveillance and 
epidemiology, if requested;

c.  provide technical advice on data collection, developing operating 
guidelines, quality control procedures, and developing policies/protocols for 
dealing with recurrent situations, if requested;

d.  facilitate collaborative efforts to compile and disseminate program 
results through presentations and publications;

3.  Collaborative Responsibilities

The CC will serve as the main governing board for the cooperative agreements 
making up the SOSC.   NIOSH staff and one scientist from each recipient will 
have membership on the CC.

One critical role of the CC is to ensure that the case definitions and data 
collection protocols are uniform and compatible across the SOSC.

The CC may, when it deems it to be necessary, invite additional, non-voting 
scientific advisors to the meetings at which research priorities and 
opportunities are discussed.

It is anticipated that there will be four CC meetings during the first year 
and two in each subsequent year,  but the actual number and locations of the 
meetings will be determined by the CC itself.  The initial planning meeting 
will be organized by NIOSH and held in Cincinnati soon after the award, but 
subsequent meetings will be organized by the CC.  The committee chair will 
schedule the meetings and will be responsible for developing the meeting 
agenda, chairing the meetings, and producing CC reports. 

At the Planning Meeting, the CC may:
o  discuss and clarify program goals and the Committee’s role in promoting 
coordination and communication;
o  discuss and set initial recruiting targets and schedules
At the second and subsequent meetings, the CC may 1) make recommendations on 
the case definitions; 2) identify and recommend solutions to unexpected 
problems; 3) discuss ways to efficiently coordinate common surveillance 
activities; and 4) recommend guidelines for new or enhanced models for 
condition-specific surveillance and intervention.

HUMAN SUBJECTS REQUIREMENTS

If a project involves research on human subjects, assurance (in accordance 
with Department of Health and Human Services Regulations, 45 CFR Part 46) of 
the protection of human subjects is required.  In addition to other 
applicable committees, Indian Health Service (IHS) institutional review 
committees also must review the project if any component of IHS will be 
involved with or will support the research.  If any American Indian community 
is involved, its tribal government must also approve that portion of the 
project applicable to it.  Unless the grantee holds a Multiple Project 
Assurance, a Single Project Assurance is required, as well as an assurance 
for each subcontractor or cooperating institution that has immediate 
responsibility for human subjects.  The Office for Protection from Research 
Risks (OPRR) at the National Institutes of Health (NIH) negotiates assurances 
for all activities involving human subjects that are supported by the 
Department of Health and Human Services.

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the Centers for Disease Control and Prevention (CDC) to 
ensure that individuals of both sexes and the various racial and ethnic 
groups will be included in CDC-supported research projects involving human 
subjects, whenever feasible and appropriate. Racial and ethnic groups are 
those defined in OMB Directive No. 15 and include American Indian or Alaska 
Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian 
or Other Pacific Islander.  Applicants shall ensure that women, racial and 
ethnic minority populations are appropriately represented in applications for 
research involving human subjects.  Where clear and compelling rationale 
exist that inclusion is inappropriate or not feasible, this situation must be 
explained as part of the application.  This policy does not apply to research 
studies when the investigator cannot control the race, ethnicity, and/or sex 
of subjects.  Further guidance to this policy is contained in the Federal 
Register, Vol. 60, No. 179, pages 47947-47951, and dated Friday, September 
15, 1995.

LETTER OF INTENT

Prospective applicants are asked to submit by April 2, 2000, a letter of 
intent that includes a descriptive title of the proposed research, name, 
address, and telephone number of the Principal Investigator, identities of 
other key personnel and participating institutions, and number and title of 
the RFA in response to which the application may be submitted.

Although a letter of intent is not required, is not binding, and does not 
enter into the review of subsequent applications, the information allows 
NIOSH staff to estimate the potential review workload and to avoid conflict 
of interest in the review.

The letter of intent is to be sent to:

Ann M. Cronin
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention (CDC)
1600 Clifton Road, N.E.
Building 1, Room 3070B, MS D-40
Atlanta, GA  30333
Telephone 404-639-2277
Fax 404-639-0035
Email: axc2@cdc.gov

APPLICATION PROCEDURES

Applicants must use Form PHS 398 (rev. 4/98).  Application kits are available 
at most institutional offices of sponsored research and may be obtained from 
the Division of Extramural Outreach and Information Resources, National 
Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-
7910, telephone 301/435-0714,  Email: grantsinfo@nih.gov.  Application kits 
are also available at: www.nih.gov/grants/forms.htm.

The RFA label available in the PHS 398 (rev. 4/98) application form must be 
affixed to the bottom of the face page of the application.  Failure to use 
this label could result in delayed processing of the application such that it 
may not reach the review committee in time for review.  In addition, the RFA 
title and number must be typed on line 2 of the face page of the application 
form and the YES box must be marked.

The sample RFA label available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to 
allow for this change.  Please note this is in pdf format.

Submit a signed original of the application, including the Checklist, and 
three signed photocopies, in one package to:

Center for Scientific Review (CSR)
National Institutes of Health
6701 Rockledge Drive, Room 1040 - MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (for express/courier service)
At the time of submission, two additional copies of the application must also
be sent to:

Ann M. Cronin
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention (CDC)
1600 Clifton Road, N.E.
Building 1, Room 3070B, MS D-40
Atlanta, GA  30333

Applications must be received by May 11, 2000.  If an application is received 
after that date, it will be returned to the applicant without review.  CSR 
and NIOSH will not accept any application in response to this RFA that is 
essentially the same as one currently pending initial review, unless the 
applicant withdraws the pending application.  CSR and NIOSH will not accept 
any application that is essentially the same as one already reviewed.  This 
does not preclude the submission of a substantial revision of an application 
already reviewed, but such an application must follow the guidance in the PHS 
Form 398 application instructions for the preparation of revised 
applications, including an introduction addressing the previous critique.

REVIEW CONSIDERATIONS

Upon receipt, applications will be reviewed for completeness by CSR and 
responsiveness by NIOSH.  Incomplete and/or non-responsive applications will 
be returned to the applicant without further consideration.  Those 
applications that are complete and responsive, will undergo further 
scientific merit review in accordance with the criteria stated below for 
scientific/technical merit by an appropriate peer review group convened by 
NIOSH.

All applications will be judged on the basis of the scientific merit of the 
proposed project and the documented ability of the investigators to meet the 
RESEARCH OBJECTIVES of the RFA.  Although the technical merit of the proposed 
protocol is important, it will not be the sole criterion for evaluation of a 
study.

As part of the initial merit review, all applications will receive a written 
critique and undergo a process in which only those applications deemed to 
have the highest scientific merit, generally the top half of the applications 
under review, will be discussed, assigned a priority score, and receive a 
second level review.

Following the scientific review, competitive applications will be reviewed 
for programmatic importance by a NIOSH Secondary Review Committee.

Peer Review Criteria

The review group will assess the scientific merit of the protocols and 
related factors as follows:

Significance:  Is the application relevant to the objectives outlined in the 
RFA?  Has the proposed priority conditions or surveillance system been 
justified as important for the applicant’s State?  Does the application 
describe the importance of the proposed surveillance activity in reducing 
occupational injuries, illnesses, or hazards?  Is the proposed model likely 
to be useful for surveillance programs of other States?

Approach:  Are the conceptual framework, design, methods, and analyses 
adequately developed, well integrated, and appropriate to the aims of the 
proposal?   Does the proposal demonstrate the capacity or a plan to produce 
and disseminate case reports, data, and other information that promotes the 
goals of increasing prevention activities? Are the proposed schedule and 
personnel adequate for accomplishing the proposed activities?  Does the 
applicant acknowledge potential problem areas and consider alternative 
approaches?  Is the time line proposed for the project suitable?

Innovation:  Does the project employ novel concepts, approaches, or methods?  
Is the project original and innovative?  Does the application address the 
feasibility of providing information needed to demonstrate how the model 
systems can be implemented in other States, including States with limited  
resources and experience in conducting occupational surveillance? 

Investigators:  Are the principal investigator and her/his collaborators 
appropriately trained and well suited to carry out this work?  Do they have 
adequate experience and competence in the design, implementation, and 
evaluation of public health surveillance and epidemiology activities?  Is the 
work proposed appropriate to the experience level of the Principal 
Investigator and her/his collaborators?

Environment:  Are the applicant’s facilities, equipment, and other resources 
adequate for the performance of this project?  Is there evidence of 
institutional support generally, or specific agency commitment to development 
of occupational health surveillance activities?  Does the applicant 
adequately document the commitment of the sponsoring agency to this project.

In addition to the above criteria, all applications will also be reviewed 
with respect to the following:

o  The reasonableness of the proposed budget and duration in relation to the 
proposed research.

o  The adequacy of plans to include both genders, minorities and their 
subgroups, for the scientific goals of the research.

o  The adequacy of the proposed protection for humans, animals or the 
environment, to the extent they may be adversely affected by the project 
proposed in the application.

Programmatic Review Criteria:

o  Magnitude and severity of the problem the worker population.

o  Likelihood of developing technical knowledge for the prevention of 
occupational safety and health hazards on a national or regional basis.

AWARD CRITERIA

Applications recommended by the NIOSH Secondary Review Committee will be 
considered for award based upon (a) scientific and technical merit, (b) 
program importance, (c) program balance in terms of past and current funding 
of surveillance activities, and (d) availability of funds.

SCHEDULE

Letter of Intent Receipt Date:  April 2, 2000
Application Receipt Date:       May 11, 2000
Anticipated Award Date:         September 29, 2000

INQUIRIES

Written and telephone inquiries concerning this RFA are encouraged.  The 
opportunity to clarify any issues or questions from potential applicants is 
welcome.

Direct inquiries regarding programmatic issues to:

Michael J. Galvin, Jr. Ph.D.
Research Grants Program
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
1600 Clifton Road, N.E.
Building 1, Room 3053, MS D-30
Atlanta, GA  30333
Telephone: 404/639-3343
FAX: 404/639-4616
Email: mtg3@cdc.gov

Direct inquiries regarding grants management to:

Sheryl L. Heard, Grants Management Specialist
Grants Management Branch, Procurement and Grants Office
Announcement 00071
Centers for Disease Control and Prevention (CDC)
2920 Brandywine Road, Room 3000
Atlanta, Georgia 30341
Telephone: (770) 488-2723
Email address: slh3@cdc.gov

PAPERWORK REDUCTION ACT

Projects that involve the collection of information from 10 or more 
individuals and funded by cooperative agreement will be subject to review by 
the Office of Management and Budget (OMB) under the Paperwork Reduction Act.

AUTHORITY AND REGULATIONS

The Catalog of Federal Domestic Assistance number is: 93.262 for the National 
Institute for Occupational Safety and Health (NIOSH).  This program is 
authorized under the Public Health Service Act, as amended, Section 301(a) 
[42 U.S.C. 241(a)], and the Occupational Safety and Health Act of 1970, 
Section 20(a) [29 U.S.C. 669(a)].  The applicable program regulation is 42 
CFR Part 52.  This program is subject to the intergovernmental review 
requirements of Executive Order 12372.

LOBBYING RESTRICTIONS

Applicants should be aware of restrictions on the use of HHS funds for 
lobbying of Federal or State legislative bodies. Under the provisions of 31 
U.S.C. Section 1352, recipients (and their sub-tier contractors) are 
prohibited from using appropriated Federal funds (other than profits from a 
Federal contract) for lobbying congress or any Federal agency in connection 
with the award of a particular contract, grant, cooperative agreement, or 
loan. This includes grants/cooperative agreements that, in whole or in part, 
involve conferences for which Federal funds cannot be used directly or 
indirectly to encourage participants to lobby or to instruct participants on 
how to lobby.

In addition, no part of CDC appropriated funds, shall be used, other than for 
normal and recognized executive-legislative relationships, for publicity or 
propaganda purposes, for the preparation, distribution, or use of any kit, 
pamphlet, booklet, publication, radio, television, or video presentation 
designed to support or defeat legislation pending before the Congress or any 
State or local legislature, except in presentation to the Congress or any 
State or local legislature itself. No part of the appropriated funds shall be 
used to pay the salary or expenses of any grant or contract recipient, or 
agent acting for such recipient, related to any activity designed to 
influence legislation or appropriations pending before the Congress or any 
State or local legislature.

SMOKE-FREE WORKPLACE

The CDC strongly encourages all grant and contract recipients to provide a 
smoke-free workplace and promote the non-use of all tobacco products.  In 
addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking 
in certain facilities (or in some cases, any portion of a facility) in which 
regular or routine education, library, day care, health care, or early 
childhood development services are provided to children.  This is consistent 
with the PHS mission to protect and advance the physical and mental health of 
the American people.

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